How to stop excessive sweating

We find out how to tackle excessive sweating from renowned dermatologist Dr Nick Lowe

Often an embarrassing and distressing problem, excessive sweating is actually a much more common concern than we think. An ailment that can affect underarms, hands and feet in addition to people’s self-esteem and confidence, what’s the best way to treat and cure it for good?

We asked dermatologist and Professor at the Cranley Clinic Dr Nick Lowe, for his insight on the causes and his recommended ways for curing it. From over-the-counter remedies to prescription and specialist treatments too, there’s thankfully a range of solutions out there to help, no matter how severe a case you have.

THE CAUSES OF EXCESSIVE SWEATING

“There are 2 different types of sweating,” says Dr Lowe.

1. Common Heat Regulatory Sweating

“This controls your body temperature when it’s too hot by producing sweat, which then cools the body when it evaporates off the skin.”

2. Emotional sweating

“This only occurs in certain areas – the face, underarms, hands, feet and sometimes the chest. It is controlled by the autonomic nervous system and its purpose is not for heat regulation. It’s triggered by emotions such as anxiety and stress (although there are a few rarer cases where it can be caused by nerve injury in local areas too).

“It’s triggered by the release of nerve transmitting chemicals called acetylcholine. Usually this type of severe emotional sweating starts during adolescence,” says Dr Lowe.

HOW TO TREAT EXCESSIVE SWEATING

Step 1: Antiperspirants With Aluminium Salts

“If localised, for example on the underarms and if severe, you can use some of the stronger antiperspirants available that contain aluminium salts - check the packaging or ask your pharmacist as they will be able to recommend a number of options,” advises Dr Lowe.

“These should be avoided though if you have sensitive skin as they could be problematic and cause a reaction or increased sensitivity. The best approach in these circumstances is to go gently and test the area first. You may not be able to use it every night but perhaps 2 or 3 times a week instead.”

Step 2: Meditation

“Before using oral medications which have their pluses and minuses, think about meditation techniques instead,” recommends Dr Lowe.

“If you know you’ll be in a situation where excess sweating is likely to happen (e.g. before a big presentation), try to interrupt the anxiety cycle by trying meditation and relaxation. I recommend the mindfulness theory and reading a book called Mindfulness by Mark Williams and Danny Penman.”

Step 3: Oral Medications

“Prescription-only oral medications such as beta blockers or low dosages of Inderal can be used to reduce anxiety and the onset of sweating. They’re useful when you know you’re going to be in a stressful situation, but they have to be prescribed by a physician who is aware of their side effects, e.g. drowsiness and low blood pressure.

“Pro-Banthine can also be prescribed. It blocks the release of the chemical transmitter acetylcholine. However, it can lead to a dry mouth and dry eyes.”

Step 4: Botox

“If the excess sweat is localised to one part of the body, we sometimes inject extremely diluted injections of Botox very superficially into the skin (and not into the muscles) which can help. In the research that we conducted, it was injected into the underarms and the palms of the hand, but it can be used in local areas of the face such as the forehead and the upper lip areas too.

“In the studies, it was shown that the benefits could last up to 11 months on average. It lasts much longer against sweating than on muscle action.”

Step 5: Future Treatments

Ultrasound

“This is mainly for the underarms only,” recommends Dr Lowe, “but it has to be done with the right specialist because you can sometimes suffer from nerve injury as a result.”

Radio frequency

“We are looking into using radio frequency too. It’s used for tightening the skin by using micro needles which can be varied in depth so they can approximately reach the sweat gland region and treat the affected areas. The radio frequency then works to destroy the sweat glands. However, this is only at the research stages of development.”

Gel Botox

“Botox in a gel which can be applied to the skin is still in its research stages in the US at the moment. It won’t be available for another 1 or 2 years but it could be used for both the face and body. However, it has only been studied for underarms at the moment.”

Iontophoresis

“For palms and soles, there’s a process available called Iontophoresis. This is where you place your hands and feet in a special salt solution and pass a very low energy current through it. It has to be used several times a week and then used for maintenance afterwards.”

Which treatment holds the most promise?

“The biggest hope for the future for this distressing problem (professionally and socially), is the Botox gel. It’s been tested when applied to the skin and was found to reduce sweat from both the face and underarms. Aluminium salts are often much too irritating for the face."

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